Basic Information
Provider Information
NPI: 1154504504
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABUALFOUL
FirstName: AHMED
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 115 8TH ST NE
Address2:  
City: CEDAR RAPIDS
State: IA
PostalCode: 52401
CountryCode: US
TelephoneNumber: 3193633565
FaxNumber: 3193634001
Practice Location
Address1: 115 8TH ST NE
Address2:  
City: CEDAR RAPIDS
State: IA
PostalCode: 52401
CountryCode: US
TelephoneNumber: 3193633565
FaxNumber: 3193634001
Other Information
ProviderEnumerationDate: 12/07/2007
LastUpdateDate: 09/11/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200X39434IAY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
207R00000X39434IAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XBP10025135TXN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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